Recovery High Schools Show Promise, But Face Challenges

High schools designed to support students in recovery from substance use disorders show promise in helping students sustain their abstinence, but face a number of challenges, according to experts.

Recovery schools offer an alternative to students who have left their high school to deal with substance abuse issues. If they return to their regular high school after treatment, they often find that getting thrown back in with old friends quickly leads to relapse. Around the country, a small number of recovery high schools offer a safe and sober alternative for students struggling to avoid falling back into old harmful routines.

The National Institute on Drug Abuse (NIDA) is funding a five-year study, now in its fourth year, to compare the outcomes of students attending recovery high schools with those who return to a regular high school environment after substance abuse treatment. Dr. Ken Winters, Professor in the Department of Psychiatry at the University of Minnesota Medical School, who is one of the investigators in the trial, spoke about it at the recent annual meeting of the College on Problems of Drug Dependence.

"The school setting is natural for promoting continuing care for these students," Winters said. "Promising indications are that recovery schools have been shown to be quite effective in promoting abstinence, or at least very improved outcomes, for teens following formal substance abuse treatment."

Preliminary data from the current NIDA study, which have enrolled so far about 185 students, showed those who were enrolled in recovery high schools reported significant improvement in terms of frequency and use of substances, Winters noted.

A descriptive study of recovery high schools conducted in 2007 also showed promising results for student substance use and academic outcomes.

The study found 80 percent of students reported doing better with alcohol/drug issues, 71 percent academically, 59 percent emotionally, and 57 percent with family issues.

Recovery schools vary widely in how they are run. Some are part of the public school system, while others are independent charter schools. While some schools allow students to stay for their entire high school career, others have a time limit. The first recovery high school was established in the late 1980s in Minnesota.

Currently, the Association of Recovery Schools has 16 member high schools in 13 states. It is estimated that there are about 35 recovery high schools in the US.

Some schools, including several in Minnesota, have closed because of funding issues. "Some schools find it's tough to survive if they depend solely on public dollars, or if they don't have enough students," Winters noted. "The schools need a rigorous team of professional counselors along with the teaching staff." Public schools generally set funding levels based on how many students are in a given school in the fall, but recovery school students flow in and out throughout the year. "A lot of students come into these schools in the late fall or early winter," he said.

Counseling, which can substantially add to costs, is especially important in recovery high schools because so many students have mental health issues in addition to substance use disorders, Winters observed. "Often with teens, drug use is secondary to other problems, so a well-trained staff is essential," he said. "It's not just about maintenance of abstinence."

A recently published review of studies on recovery high schools revealed a number of challenges the schools face in addition to funding.

The schools are small, and must accommodate students of different grade levels and preparation. Some students have missed a significant amount of school because of their substance use and treatment. With limited resources, some schools struggle to maintain adequate academic standards while providing treatment.

"We need favorable local or state laws and more flexible funding formulas," Winters said. "It may be more feasible to put recovery high schools into existing public schools in a modified form so recovery services are provided a few hours a week. This could reduce overhead and accommodate school budgets more easily, while still providing some important continuing care services for young people."

Winters also presented new data on college recovery programs from a study by Dr. Alexandre Laudet of the National Development and Research Institutes in New York. She studied almost 500 students in about 30 college recovery programs around the country.

The programs varied widely. Some are very structured, providing many services, including living quarters with counselors assigned to students, while others have less extensive recovery services.

Laudet found almost half of students said having a recovery program available was somewhat or very important in their decision to attend or return to college. Most said having a college recovery program was very or moderately helpful to them. As with high school students in recovery, many of the college students in the survey were dealing with co-occurring mental health problems.

"There's a growing interest in college recovery programs; colleges can more easily fit them into their budget than high schools," Winters said. "Colleges can provide specialized housing, and have a lot of health services on campus. There is clearly a need for these programs, because college can be a tough environment to stay sober in."

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